[Value of colonic irrigation. Long-term followed-up in 432 colostomized patients]

Irrigating colostomies allows patients to achieve nearly complete fecal continence using a simple technique. We assessed long-term results in our series of 432 patients.

From 1979 to 1992, we followed 432 patients who had undergone definitive colostomy surgery (mean follow-up = 8.4 years).

Colonic irrigation was impossible in 281 cases mainly due to retarded patient information (42%) or patient incapacity (31%). It was possible in 151 patients (globally 31%). In patients with abdominoperineal amputations the rate was 63%, for Hartmann procedures 17% and for derivations 6%. Most of the derivations were supraombilical colostomies (n = 51) including 6 who used colonic irrigation. No complications related to the technique were observed and minor incidents (usually problems with the cannula and/or pain) occurred in 61 patients. Thirteen patients (9%) abandoned the technique including 5 who complained of incontinence.

Based on these observations, we conclude that colonic irrigation is not used enough. The key to success is a quality stomy and early patient information and training. This technique is particularly adapted for active patients. It is performed every 48 hours and lasts about 35 minutes.